How could Modern Alternative Mama determine whether natural remedies actually work?

Katie Tietje pharmacology sharper

As I wrote yesterday, Katie Tietje (Modern Alternative Mama) claims that natural remedies work to cure disease.

She provided no evidence for that claim, but that doesn’t mean that it is impossible.

Let’s look at what Katie would need to know in order to determine whether natural remedies work:

The study of drug efficacy and safety is pharmacology. Pharmacology can be roughly divided into two areas: pharmacodynamics, how the substance acts on the body, and pharmacokinetics, how the body acts on the substance.

What are the pharmacodynamics and pharmacokinetics of natural remedies?

Here are some basic questions that must be answered to find out how the drug works on the body:

  • How does the drug work? What is the active ingredient? What effect does the active ingredient have on the body?
  • What is the dose-response? In other words, as the dose of drug increases, does the response increase?
  • What is the ED50, the dose that produces a response in 50% of subjects, also known as the median effective dose?
  • What is the maximum effect that can be produced by the drug, also known as efficacy?
  • What is the therapeutic window? For every drug, there exists some concentration which is just barely effective and some dose which is just barely toxic. Between them is the therapeutic window where safe and effective treatment will occur.

Here are some basic questions that must be answered to find out how the body interacts with the substance:

  • What is its half life?
  • What is its bioavailability?
  • How is it removed from the body?
  • Does it have effects on other parts of the body besides its stated therapeutic effect?

What does Katie Tietje know about the pharmacology of the natural remedies that she recommends? Generally nothing. She doesn’t know the mechanism of action, the dose response or the side effects. Therefore, she has no evidence that the natural remedies that she peddles are either safe or effective.

Determining drug efficacy and safety is complex. It is absolutely imperative to study the pharmacodynamics and pharmacokinetics of a substance before anyone can claim that it is effective or safe. In the case of Katie Tietje’s natural remedies, these questions have not even been asked, let alone answered.

  • Diet dee

    So natural remedies cant work until they have been studied scientifically?

    • Monkey Professor for a Head

      No, but you have no idea whether they truly work or not. Im sure some herbal remedies do work. But without scientific research it’s hard to know which ones work and which ones don’t. Also these remedies are usually unregulated, and by virtue of being “naturally” derived, can have varying amounts of active ingredient present. So you don’t know if you’re getting an adequate dose, or if you are overdosing. If a remedy has an ingredient which has an effect on the body, then it can have adverse effects, especially in overdose.

      And some things, such as homeopathy, are just baloney.

      • Diet dee

        It extremely difficult to harm your by taking natural remedies as directed. Even pharmacies make mistakes and counterfeit medicines are a a real problem. But overdosing on natural treatments to the point of harm is extremely rare

        • momofone

          Source?

        • Nick Sanders

          Bull-fucking-shit.

        • shay simmons

          Wrong. Overdosing on supplements causes 23,000 emergency room visits annually.

          http://www.nejm.org/doi/full/10.1056/NEJMsa1504267

          • sabelmouse

            dietary sups for weightloss and children getting their hands on vitamin pills. not quite the same thing.

          • Diet dee

            Notice I said as directed. Most of those ER visits from abuse of energy supplements and (your ravers and long distance truckers) weight loss (there is your anorexia population)

        • corblimeybot

          How about if they are contaminated or contain ingredients the label doesn’t declare? As is very, very common with supplements.

          • Diet dee

            Are supplements more dangerous than it or pharmaceuticals? My guess is that they much safer even if counting the people abusing diet pills and weight loss supplements

          • Jonathan Graham

            Are supplements worth any risk at all when their benefit is zero for most people in developed countries?

          • AlisonCummins

            “More dangerous” needs context.

            The issue is a risk/benefit ratio. If the benefit is zero, than any risk at all is unacceptable. For instance, spending money on homeopathy might mean you have less money for vegetables or hiking shoes or yoga classes, and that’s a problem.

            If the benefit is high, then we are ready to accept a high amount of risk. People take horrible chemotherapy drugs when the alternative is dying of cancer. Obviously the drugs are dangerous but cancer is even more dangerous.

            The substances sold as “supplements” in the US are drugs. Either they are untested (so we don’t know what the risk/benefit ratio is) or they are tested (and we know that the ratio is not good). There is no reason to take them. (Exceptions: sometimes ordinary nutritional supplements in ordinary doses, like iron or vitamin D, can be indicated. Your doctor will have helpful thoughts about that. Vitamins taken in high doses are being used as drugs, not vitamins.)

          • I don’t know the last time a pharmacological drug had as many side effects as the natural supplement fen-phen. That killed people pretty good.

            St. John’s wort (taken for depression) interacts badly with other medications- for example, it makes many forms of birth control less effective, leading to unwanted pregnancies.

            Kava (taken for anxiety) can destroy your liver, cause nerve damage, worsen depression, or kill you. It also mixes very badly with alcohol.

            Comfrey (taken to help with bruises, broken bones, etc.) can destroy your liver and possibly your lungs.

            Chaparral (taken to reduce skin inflammation and irritation) can irreversibly damage your liver. It also mixes badly with OTC painkillers like aspirin, blood thinners, diabetes medications, and depression medications.

            Pennyroyal (used for abortions) can destroy your liver and kidneys or kill you.

            So yeah. Herbs can do things. Oftentimes, those things are not good for you. When we study natural remedies, much of the time we find out that the cost/benefit ratio isn’t on the benefit side of things. Properly tested pharmaceuticals are much, much safer than supplements and random herbs.

            EDIT: Also some links:
            Lots of supplements don’t have what they claim to in them- http://www.alternet.org/personal-health/big-herba-out-control-why-vitamins-minerals-and-herbal-remedies-can-be-dangerous
            Herbal Supplements warning chart for drug interactions- http://my.clevelandclinic.org/services/heart/prevention/emotional-health/holistic-therapies/herbal-supplements

          • Diet dee

            I bet that VIOXX killed more than phen phen.
            A few anti depressants have the awful side effect of suicide(I’ll just take my chances with the tea or some Niacin.) If you go cold Turkey on Paxil. Interesting things will happen but those things will be very violent.
            There is danger with vitamin and drugs. But when last time you heard of some health nuts killing someonein the mist of a Kale withdrawal

          • Vioxx killed a much smaller percentage of people than fen-phen, which is why it took so long for it to be pulled from the market. Also, yes, that was a matter of corruption, because scientific studies showed it was unsafe and it hit the market anyways.

            I never said that pharmaceuticals couldn’t have nasty side effects. They absolutely can and do. We do a cost/benefit analysis on them, though, and we can give people informed consent on what those possible side-effects are. Various and random herbal concoctions? Not so much. You don’t know what you’re getting, you don’t know how much of it you’re getting, you don’t know what it can do, heck you don’t even know if it works at all! You know what they call alternative medicine that works? Medicine.

            Yes, cold turkey from Paxil can be violent, but we know that and we warn people and we wean people off of it carefully and under medical supervision because of it, and we give Paxil to people who need it to function because of depression, OCD, or other mental illnesses. People in the midst of opioid withdrawal (which is a very natural drug indeed- made from poppies) can become very violent or die. Cocaine is made from coca leaves. It’s a natural, plant-based drug, only slightly processed. Withdrawal from cocaine is also very unpleasant for both the person and those around them.

            If you try to treat depression with tea, people will die. End of story. Many more people will die of untreated depression than would ever be harmed by antidepressants, and your willingness to write them off in the name of your purity crusade is mindbogglingly cruel. You wanted to know if herbs ever had negative side effects. Yes, yes they do. The fact that you don’t like that answer is never enough reason to try to pull a tu quoque fallacy and throw people’s lives under the bus at the same time.

          • demodocus

            side note: I drink tea for my depression, every morning with my zoloft. (Real tea, not those tisanes, is something i love, like petting my new skein of yarn my sister brought me)

          • Tea doesn’t hurt! Anything that is pleasurable helps. And yeah, tea is awesome.

            Your point still stands, that you take it with zoloft, not instead of zoloft 🙂

          • Nick Sanders

            A few anti depressants have the awful side effect of suicide

            That has nothing to do with the drugs and everything to do with how depression works. The most likely time for suicide during depression is not when someone has bottomed out, but when they first begin to improve.

          • AlisonCummins

            … well, maybe a little to do with the drugs.

            Depression has a mood aspect and an inactivity aspect. When you’ve bottomed out you want to die but you can’t act to kill yourself. When you’re getting better your ability to act usually starts improving before your mood does, so your risk for suicide goes up. With some medications the lag seems to be bigger than with others. The ideal treatment would have mood improve first, then ability to act.

            If you know that a particular medication carries a risk for suicide but you prescribe it anyway, you watch the person especially carefully. (Of course, you’re watching them anyway because improvement carries a risk anyway.)

          • Nick Sanders

            Fair.

          • Heidi_storage

            Kale isn’t a remedy for anything, though. Homeopathy side effects are rare, too (except when we’re talking about the alcoholic “remedies”), because it’s hard to OD on water. Anything that can have an effect on the body also has a chance of causing harm–whether or not it’s natural or not. The point is gauging the risk and the effectiveness, which has been done with “conventional” medications far more thoroughly than with “natural” remedies.

          • Nick Sanders
          • Heidi

            Actually, people who eat too much kale risk thallium poisoning. Now, if you have some with dinner sauteed, you are probably just fine and actually eating something healthful. But the real people at risk are the ones who actually see kale as medicine and might consume multiple servings in one green smoothie and might drink a green smoothie more than once a day. You can do some serious liver damage with niacin, too.

            A “side effect” of untreated depression is suicide, too. Let’s not overlook that little fact.

          • demodocus

            Well, since I was already suicidal, in therapy, and drinking enough herbal “tea” to float the USS Constitution, clearly the teas and vitamins weren’t getting the job done.

          • swbarnes2

            Is it easier to OD on bottled aspirin pills than willow bark? Probably, because the aspirin tablets have a pure medicine, and the willow bark is mostly wood. That doesn’t mean that willow bark is a better product that bottled aspirin.

            If doctors told you to take a blood thinner, which would you rather take, a fistful of clover mold, or warfarin in a bottle? Regardless of your personal preference, which do you think is safer?

          • Azuran

            People who abuse something, regardless of their reasons, is not a good indication of any product’s safety. Any pharmaceutical product has very clear instruction on doses and frequency at which you must take them. When used as indicated, most medications are actually very safe.
            At least, with pharmaceutical, what you see is what you get. Most ‘natural supplements’ are mostly safe even when people abuse them because they hardly contain any kind of active substance.

        • AlisonCummins

          What’s a natural remedy?

          Energy medicine like reiki, or homeopathy: These are forms of magic. They have no effect at all except on your budget. Yes, impossible to overdose on. Yay.

          Unregulated pills: You really don’t know what’s in them. Don’t take them. Very many of the substances sold as “supplements” (the code word in the US for “untested drugs, or drugs that have been tested and proven to have poor risk/benefit ratios but that we wish to sell anyway”) are not what is labelled on the bottle.

          Teas or foods (liquorice candy for a diuretic, coffee as a stimulant, whiskey as a sleep aid, prunes for constipation): Not impossible to overdose on, but in most cases the side effects will cause you to stop consuming them before you experience acute toxicity. But it’s totally possible to get drunk, pass out, vomit, aspirate and die.

          Moderate diet and exercise and a good social network: Natural, yes. Impossible to overdose on – well, the key word is moderate, so it’s possible to be immoderate. Scientific, yes. Alternative, not at all. Totally mainstream. This is what your MD wants for you.

          So can you be more precise?

          • Diet dee

            Your basic Health food products that are available at any health food store. For example herbs foods (mushrooms and berries, protein powders) and vitamins. It is possible to harm yourself. You could take 10grams of vitamin C and give yourself diarrhea but most people just don’t do that. Vitamin and herb can provide a therapeutic benefits under the right circumstances And thats why they are so popular.

          • Nick Sanders

            Vitamin and herb can provide a therapeutic benefits under the right circumstances

            https://upload.wikimedia.org/wikipedia/commons/thumb/1/18/%22Citation_needed%22.jpg/220px-%22Citation_needed%22.jpg

          • Diet dee
          • swbarnes2

            What exactly do you think that shows? Sure, doctors use purified chemicals in known doses to elicit physiological reactions. When a deficiency is diagnosed, supplements are helpful.

            Since no one buying vitamin C at a health food store is using it to treat a vitamin C deficiency due to sepsis, it is dishonest to cite this as if it is relevant to the conversation.

          • Azuran

            But is it still considered a natural supplement or a natural remedy when it’s a synthetically made sterile IV solution? Or did you think they actually injected people with pure lemon juice.

          • Nick Sanders

            IV lemon juice, now that would be an interesting exercise in sadism…

          • Diet dee

            Oral vitamin C is made in a lab I’m pretty sure that they aren’t using lime juice to make 500mg tablets

          • Nick Sanders

            Your link was not about oral Vitamin C.

          • Azuran

            Indeed they aren’t. But Vitamin C tablets by themselves are hardly a natural or herbal remedy, since they are artificially made tablet, and they are not a miracle cure either.
            Your link actually showed that only IV injection had any effect, Oral pills didn’t. IV injection of synthetic substance isn’t in any way a natural remedy or a ‘supplement’ it’s a medication.

            It’s totally true that many natural products have application in treating different illnesses and overall increase in health. Most of the medications we have today where first extracted from plants. But whenever some kind of product shows potential health benefits, those who are really interested in health will test it. If studies shows that it work, they then figure out the effective dosage, then find cheap and effective way to have a clean and constant concentration of the product to insure efficacy and safety. And at that point, it because basically a medication.

            Vitamin C does have a few proven medical uses, like treating and preventing scurvy. It could potentially help people who have severe disease. But then again, Any deficiency of any kind of vitamin or minerals can probably raise the risk of death during any kind of illness. It might not be that supplementation of vitamin C is actually beneficial on it’s own, but that a deficiency has a negative effect.
            The problem is that those who promote natural health and herbal remedies will make overblown assumption and claim that Vitamin C (or any other product) can basically cure absolutely anything with 0 side effect. It is absolutely not true.

          • Nick Sanders

            Two things. One, it’s talking about parenteral administration, which means an IV, not supplement pills. Two:

            10. Conclusion

            Further study is needed to determine definitively the safety and efficacy of ascorbate in patients with sepsis.

          • swbarnes2

            No, those things are popular because their benefits are touted way beyond what the evidence shows they do, and people respond to the placebo effect, and don’t account for regression to the mean.

          • Diet dee

            Many people go to conventional medicine first. Then a friend recommends a supplement like olive leaf extract or oil of oregano. When the supplements works then a customer in born. This isn’t science based but it is evidence based.

          • Nick Sanders

            Except that’s not evidence.

          • demodocus

            What do ya mean?! Just because “scientists” won’t acknowledge the wonders of oregano?! It’s like they never even tested plants with purported health benefits. Why, we don’t even have anything made from willow bark extract or foxglove extract!.

          • swbarnes2

            You can’t do real science with a sample size of 1. Also, regression to the mean and the placebo effect are in play. Do you not understand what those are?

          • Diet dee

            If it works for me what difference does it make?

          • Nick Sanders

            Well, for starters, since most non-emergency problems eventually resolve on their own, you have no way of knowing if it actually worked for you or not.

          • swbarnes2

            Can you explain why spending $100 on a tiger-repelling rock is a bad idea? It works for me, I’ve never once been attacked by a tiger.

            Or do you really not know how to argue against this?

          • Diet dee

            Supplements have history of usefulness thats why we fortify foods for humans and animals.
            But tiger repelling rock don’t have the same history.

          • momofone

            Which supplements have been shown to be useful, and how? Please share.

          • AlisonCummins

            No, we do not fortify our food with powdered rhinoceros horn on the basis of someone saying it worked for him!

            We fortify specific foods with specific nutrients in very well-defined amounts to target specific populations at risk based on a combination of in-depth understanding of epidemiology and biochemistry.

            We ensure that all milk, even skim milk, contains fat-soluble vitamins (typically present in useful amounts in cream) that are important for children, vitamins A and D. We know what conditions we are preventing (eye and bone problems due to vitamin deficiency). We know how vitamins A and D prevent them. We know how much vitamin A and D our target population typically gets from other sources, how much is enough to ensure that almost all our target population gets enough and how much would be too much.

            If you are getting adequate vitamin A and D from food and sunlight exposure, taking supplements cannot prevent a vitamin deficiency but can be toxic. So don’t! Get your nutrients from food. Much safer and healthier.

            Do you know what a vitamin is?

          • Diet dee

            the benefits of vitamins do not always stop at preventing diseases of deficiency. high doses of vitamin A have been used to reduce mortality from measles. high Vitamin D levels have been associated with better health. Garlic and honey have been use to fight infections and so on. there are studies on herbs and vitamins. it will rarely make the news. And you expect some anti vitamin articles about once every 6 months. It’s simpler to say try some vitamin C/D etc because it worked for me rather than referring people to pub med articles.

          • AlisonCummins

            A child with a vitamin A deficiency is treated for their deficiency by giving them vitamin A. Since one of the effects of a vitamin A deficiency is a compromised immune system, it’s particularly important to bring vitamin A–deficient children back up to adequate levels when they get potentially fatal diseases like measles.

            Really. That’s all they’re doing. Treating a vitamin deficiency. If the child had been consuming whole milk, green and yellow vegetables or even GMO golden rice they would have adequate levels and giving them extra vitamin A when they got sick would not be necessary.

            Vitamin D is interesting because it’s harder to define ‘adequate’ and the window below ‘toxic’ could be quite narrow. Still, taking more doesn’t treat anything except deficiency and could be dangerous.

            Garlic and honey are NOT VITAMINS!!!

          • sabelmouse

            wow!

          • Nick Sanders

            “Have been used” ≠ “are effective at”.

            If you really want to reduce mortality from measles, use the vaccine and stop it in it’s tracks.

          • Diet dee

            but what do you do in third world countries where measles infections are active and deaths are much more likely?

          • Nick Sanders

            Vaccinate, and improve medical infrastructure.

          • sabelmouse

            vitamin c is a live saver for me. i’d have more, and more severe migraines without it.

          • AlisonCummins

            Then it’s working as a drug, not as a vitamin.

          • sabelmouse

            no it isn’t. why would it be.

          • AlisonCummins

            Because if it were acting as a vitamin, it would be treating scurvy. You don’t have scurvy.

            It’s acting as a drug because you are taking it for its antihistaminic properties, not for its ability to prevent or treat scurvy.

          • sabelmouse

            so it has 2 properties and one of them make it a drug because pharma produces a drug with such properties?
            anyways, i am glad that you realise that it works like this. most on such threads as this just dismiss it.
            how do you know i don’t have scurvy?

          • swbarnes2

            If your mother was spending $100 a month on tiger-repelling rocks, and she told you “They work for me, so what difference does it make”, well, how do you argue with that? What exactly would you say?

            Remember that her sincere belief is “Evidence-based”. Because she has not suffered a tiger attack.

          • Diet dee

            If my mother was constantly get stalked by Tigers(disease). But then the Tigers stayed Away only when she had the the rock(Supplement) then the Tiger repelling rock is working.

          • Nick Sanders

            I can’t take this any more.
            https://www.youtube.com/watch?v=xSVqLHghLpw

          • AlisonCummins

            Ok, so by “natural remedy” you mean:
            > organic fruits and vegetables;
            > pills;
            > concentrated powders.

            What disease does a raspberry treat?
            What effect does the active ingredient have on the body?

            What is the dose-response?
            In other words, as the dose of raspberries increases, does the response increase?

            What is the ED50, the dose that produces a response in 50% of subjects, also known as the median effective dose?

            What is the maximum effect that can be produced by raspberries, also known as efficacy?

            What is the therapeutic window? That is, what is the dose of raspberries that is just barely effective against the condition being treated? What is the dose which is just barely toxic?

            If you can’t answer these questions, you can’t say that raspberries are a good remedy for anything except desire for raspberries. You certainly can’t say they are a better remedy than something else. You’re just making things up. (William Withering was able to give a good stab at these questions in 1785 when describing how to use foxglove to treat heart failure.)

            Extra credit for answering,
            > What is the active ingredient?
            > How does the active ingredient work?

            As explained earlier, very rarely is it smart to take things sold as “supplements.” It’s very easy to overdose on things sold in concentrated form like pills and powders and lax regulation means you really don’t know what’s in them.

            Protein powders are popular, yes. That might be partly because they often contain steroids and stimulants not on the label. They are rarely necessary, can easily be abused and are frequently contaminated with unhealthy levels of heavy metals.

          • Diet dee

            I don’t know what diseases raspberries treat,but they taste great oatmeal and they count towards your intake of fruit for the day. I don’t have analyze the food I just have to eat it(and wash it). The body will handle the rest. More whole foods less junk equal better chances at a healthy life. Supplements are not strictly regulated and problems are correspondingly rare. There are definitely substandard products and crooks in this industry but they haven’t caused much damage. Just stay away from the diet supplements and FAD energy drinks.

          • Nick Sanders

            Supplements are not strictly regulated and problems are correspondingly rare.

            That makes zero sense.

          • Roadstergal

            Yes, when I think of poorly regulated industries, I think of industries with very low rates of problems… what?

          • AlisonCummins

            You said that the berries I can buy at my local health food store are natural remedies. So I am asking you, what are they remedies for? Or do you not understand what a remedy is?

            noun 1. a medicine or treatment for a disease or injury.
            “herbal remedies for aches and pains”
            synonyms: treatment, cure, medicine, medication, medicament, drug

            I don’t have analyze the food I just have to eat it(and wash it). The body will handle the rest.
            By “the body will handle the rest” do you mean that if you eat lots of fresh fruit and vegetables your body will convert them into drugs that treat disease? Or do you mean that you will lower your risk of diabetes, heart disease and cancer?

            More whole foods less junk equal better chances at a healthy life.
            Yes. Exactly what your doctor says.

          • Heidi_storage

            Most of this post is sensible; I think we can all agree that eating plenty of fruits and vegetables is good, and consuming lots of junk is not so good, and I would definitely avoid diet/energy products.

            However, this has nothing to do with the effectiveness of so-called natural remedies, or with their risks.

          • Heidi_storage

            Mmmm, raspberries. Yummy. Protein powders, on the other hand–yuck. And how the heck are they “natural”? One does not see containers of powders growing on trees or bushes.

          • Diet dee
          • swbarnes2

            More laughable horseshit unless you can prove that a person eating berries gets a clinically measurable benefit. Posting random pubmed links showing that food contains chemicals isn’t doing anything good for your argument, the most charitable interpretation is that you are grasping at straws. Provide more “evidence”, and other less charitable explanations will start to look more reasonable.

          • Diet dee

            not that this will change your mind but..
            http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068482/

          • Amy Tuteur, MD

            No, they’re popular because there are so many gullible people like you.

          • Diet dee

            There are pharmaceuticals drugs that have made it to the market that have killed and injured thousands. Don’t be so arrogant.

          • Nick Sanders

            How many people were injured by ephedra?

          • Amy Tuteur, MD

            Thousands? Which ones?

        • swbarnes2

          Zicam had high levels of zinc that was causing permanent damage to noses. Hyland teething tablets had varying amounts of belladonna in them. If there is enough of a chemical to have a medical effect, you can overdose on it. And that’s to say nothing of contaminants, lots of supplements have heavy metal contamination.

          Black salve is a “natural remedy”. Are you seriously claiming that that stuff is safe? It eats holes in people!

      • AlisonCummins

        Actually, almost all of this stuff has been studied. In the US, the NCCIH is a government agency created in 1991 to fund research that proves that alternative remedies work. In 25 years they have been unable to do so.

        Saying, “It can’t be patented therefore it can’t be studied so we need to go with what feels right” is simply incorrect.

        • Diet dee

          Im tempted to say that they didn’t use the right dosage or duration. Which is a common tactic when vitamins are studied!

      • Heidi_storage

        Not to mention all of the lead, arsenic, and other crap contaminating supplements. I am extremely cynical about ANY company selling things, but at least drugs are heavily regulated and so you can be sure that you’re getting a predictable amount of the active ingredient, and not getting a whole load of contaminants. Supplements and herbal remedies have no such oversight.

    • Jonathan Graham

      Ask yourself: Between some herbalist and a team of researchers….

      Which group spent more time studying the biological mechanism behind the drug?
      Which group spent more time looking at carefully controlled studies for both safety and efficacy?

      Considering that 80% of candidate compounds being researched fail to become a product[1] which process is more likely to produce something that can actually have a useful physiological effect?

      It’s not that ethnomedicine can’t be useful. It’s just unlikely.

      [1]http://csdd.tufts.edu/files/uploads/Tufts_CSDD_briefing_on_RD_cost_study_-_Nov_18,_2014..pdf

      • Roadstergal

        Nature Reviews Drug Discovery, vol 10, Feb 2011, p1 – “Phase III and submission failures: 2007-2010.” 2/3 of failures were due to lack of efficacy. Kinda makes one think that’s a good default assumption, to address Diet Dee’s original post.

        (The follow-up NRDD in May 2011 for Phase II failures still had a majority fail due to lack of efficacy.)

    • Heidi_storage

      Oh, come on, now. You know better than that! Something may or may not work, and of course it works (or doesn’t) whether it’s been studied or not; the point is that proper study of a remedy helps us know whether something actually does work or not, and what adverse effects or risks it has.

      Random people insisting that some product is going to cure your cancer is not the same thing as properly conducted clinical trials, whether or not the substance under consideration is an essential oil or methotrexate. Doctors and scientists tend not to care whether a substance is “natural” or not; what’s important is a) how likely is it to work, and b) what are the risks?

  • yugaya

    I’ve already wasted enough keyboard time on someone who has mutilated themself by refusing adequate medical care, and who still claims that “alternative” therapy works in order to sell their bullshit products and advice. She is stupid, pathetic, and to paraphrase what they say where I’m from – I wouldn’t use her advice or remedies on a drawn sheep due to concerns for the drawn sheep’s overall health and wellbeing.

  • Sue

    Not-a-Dr Kate’s special tips for childhood ear infections:

    • Mattie

      So her answer is ‘stick this random stuff in the infected ear’ like…no thanks. I used to have terrible ear issues as a child, so painful, I don’t think I’d have loved undiluted hydrogen peroxide in my ears…wait until it stops bubbling…jesus.

      • Inmara

        It’s terrifying that she advises to pour oils and other liquids in the ear! Once you do it, you can’t drain them properly, if they enter ear beyond reach of cotton swab. I have been using similar treatments as a child and adult – either smashed leaf of Pelargonium plant (it has essential oils that supposedly help) or cotton swab with camphar oil on it – but never was anything liquid placed in the ear itself (also, pelargonium leaf is to be used with caution so it doesn’t stick inside)! If infection is so severe that something there reacts with hydrogen peroxide then you visit doctor, stat.

        • LibrarianSarah

          Actually, it is the ear wax that reacts with hydrogen peroxide not the infection. If you put hydrogen peroxide in a healthy ear it will react the same way; it will stop bubbling once the ear wax has been dissolved. It is actually a pretty effective treatment for too much ear wax. I doubt it would do anything for an infection though.

          • The Bofa on the Sofa

            Perhaps a question of ignorance, but doesn’t peroxide only work with gram-positive bacteria (that’s what gram-positive means, basically) whereas ear infections come from gram-negative germs?

            That’s always been understanding but it could be way, way wrong.

          • mariam

            Gram + vs – depends on the bacterial cell wall and how the stains & counterstains interact with it. (Gram + bacteria have a thicker cell wall that holds on to the first crystal violet stain and doesn’t get washed out by the alcohol, giving a purple color.)

            The catalase test is used to distinguish Staphylococci from Streptococci (both gram +), and it involves placing the bacteria in a drop of hydrogen peroxide. Since Staphylococci have catalase, they are able to convert hydrogen peroxide to oxygen & water — hence the bubbles. Streptococci don’t have catalase, so no reaction with hydrogen peroxide occurs.

            The most common causes of ear infections are Strep. pneumoniae (gram +), Haemophilus influenzae (gram -), and Moraxella catarrhalis (gram -).

    • lurker

      Oh, God, I remember being a kid who woke up screaming with ear infections. My parents took me to Urgent Care and I was home, pain-free, in a couple hours. I can’t imagine having useless stuff done to me for hours instead.

      Also, fenugreek is an abortifacient. I… wouldn’t give that to a kid. (WebMD says there are reports of it causing loss of consciousness in children. I guess then they’re not screaming… :/ )

      Slippery elm is a fine demulcent… for the tissues it actually touches, like the throat. if it’s touching the ears by drinking it, something’s up.

      • yentavegan

        In the middle of the night…I relied on a little vics vapor rub behind the ear until we could see the doctor in the morning.

        • Julia

          we use good old tylenol.

          (although, I’ve done the warm-oil-in-the-ear on myself (basically out of desperation), and it actually helps alleviate the pain. It’s the warmth, not whatever flavor of oil though)

          • The Bofa on the Sofa

            Tylenol isn’t as effective for us as ibuprofen. So we use that. And it works well.

          • Toni35

            Us too. A dose of tylenol, a warm compress for the ear (warm washcloth), snuggles and back to bed. Call the doc in the am. Works like a charm.

      • Amy Tuteur, MD

        It was worth the entire cost of medical school to be able to look in my kids’ ears with an otoscope, diagnose an infection and call in a prescription any time of the day or night.

        • Megan

          Totally agree. I have also been able to diagnose my husband at home, usually to say it’s a cold, nothing needed, but sometimes something that actually requires treatment. I think in the case of my daughter my training has been just as, if not more worthwhile to reassure me that she only had a virus and didn’t need anything else.

        • Daleth

          I hear you! That would be great!

        • The Bofa on the Sofa

          That would have been really handy last weekend when my 4 yo had a high fever and complained of a sore ear (actually, it was, Me: “Do your ears hurt?” Him: “Just this one” – yep, to the urgent care….). Ended up not being nothing actionable, but it would have been nice to be able to look in his ears and not see anything ourselves.

    • anh

      I drove myself to the ER in the middle of the night once with a terrible ear infection. I woke up in so much pain I was convinced my ear drum had ruptured. It’s so incredibly shitty to expect a child to just soldier through that pain.

      and isn’t breast milk super full of sugar? Wouldn’t it breed bacteria and stuff?

      • Daleth

        I agree, breast milk must be like bacon for bacteria.

        When I was a kid my mom used to heat oil in a pan, rub a cotton ball in it, and then, when it was still hot but cool enough to touch, put it in my ear. It worked. To relieve the pain, anyway–no idea what effect if any it had on the actual problem.

        • Roadstergal

          My mom would blow warm breath in my ear while we waited for the doc. So amazingly soothing on an infected ear.

          • Daleth

            Good moms rule.

        • Azuran

          Mine only used a simple, dry cotton ball. In my 7 years old mind it was less painful with the cotton ball. But I’m not sure if it was all in my head or if it actually did something.

          • Mattie

            I spent so much time with cotton balls in my ears haha

        • LibrarianSarah

          I didn’t really get ear infections (mustv’e been the formula) but if I did my mom would just give me an antibiotic. I am not sure what type of wizardry she managed it buy but mom was able to get both a script and the medicine at anytime day or night.

    • EmbraceYourInnerCrone

      Ah Belladonna, also known as deadly nightshade, both the berries and leaves are poisonious. From Wikipedia and Webmd: The foliage and berries are extremely toxic, containing tropane alkaloids. These toxins include scopolamine and hyoscyamine, There’s something you want to give a small child…/snark.
      Toxicity:
      Belladonna is one of the most toxic plants found in the Eastern Hemisphere.[14] All parts of the plant contain tropane alkaloids.[15] The berries pose the greatest danger to children because they look attractive and have a somewhat sweet taste.[11] The consumption of two to five berries by a human adult is probably lethal.[16][17] The root of the plant is generally the most toxic part, though this can vary from one specimen to another.[18] Ingestion of a single leaf of the plant can be fatal to an adult
      Sources for some of the footnotes:
      “Herbarium: Selection of species from European flora”.
      “Committee for Veterinary Medicinal Products, Atropa Belladonna, Summary Report” (PDF). The European Agency for the Evaluation of Medicinal Products. 1998. Retrieved 2008-07-08.

      • Inmara

        In this case we may say – thank’s God that this “remedy” is homeopathic, and let’s hope that some stupid people won’t try to find actual belladonna!

        • EmbraceYourInnerCrone

          Yeah but thats what i worry about with my friends who are into All natural cures and treatments. If its truly homeopathic then yeah it’s probably so diluted its not a problem.
          But if someone sees Belladonna on MAM’s website as a treatment for earache / fever that could be extremely bad.
          I think all these people who believe “natural/herbs/plants can’t hurt you, should read Wicked Plants: The Weed that killed Lincoln’s mother.
          Apparently cows in the midwest ate a lot of natural forage back in the 19th century; including Eupatorium rugosum, the white snakeroot, a wild flower native the midwest US. People who consumed milk from cows that ate it developed lethargy, tremors, coma and sometimes died. Another fun one is jimsonweed, also known as locoweed..

        • SporkParade

          I’m guessing you missed the incident where Hyland’s homeopathic teething tablets were found to actually contain non-homeopathic levels of belladona.

          • Inmara

            OMG! Was it intentional (i.e. their dilution level was planned as such) or mistake in production?

          • SporkParade

            I’m not sure. All I know is that they promise to have fixed it, but they are not pushing for regulation of homeopathic remedies, so to hell with them.

          • Roadstergal

            I remember that! My crazy anti-vaxxer cousin posted that to her facebook, and her friends told her not to worry – it’s just the FDA, they don’t know anything.

            What’s funny (not funny) is that, according to homeopathy, the less it’s diluted, the weaker it is. So those potentially poisonous pills were as weak as could be as far as homeopathy is concerned.

  • Gatita

    OT: Stillbirths now outnumber deaths among infants in the U.S.

    Anyone have thoughts on the significance of this study?

    • Cobalt

      We’re getting better at preventing infant deaths, still baffled by way too many fetal deaths.

    • mostlyclueless

      11% decrease in infant mortality since 2006 seems phenomenal — any information on what caused that?

      • Amy M

        Preemies? I believe technology as well as knowledge that has to do with preemies has improved quite a bit in the last 10-15yrs, and younger and younger ones are surviving.

      • Young CC Prof

        Lots of things.

        Fewer preemies, better week-for-week survival, drop in SIDS, possibly related to decreased smoking prevalence, better detection and treatment of congenital defects, etc.

        For the past century, infant mortality has dropped pretty steadily year over year, pretty smooth exponential decrease curve with a halving time of around 30 years.

        • mostlyclueless

          I may be misunderstanding, but I think this data is specifically separating out death due to prematurity? Here is the CDC report:

          http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_08.pdf

          Fetal deaths at 20-27 weeks, at 28+ weeks, under 28 days, and at 28 days to 1 year are reported separately. So if decreased deaths due to prematurity were causing the drop in infant mortality, they should also cause a commensurate drop in fetal deaths, and fetal deaths and infant deaths would drop at the same rate. But infant deaths are dropping, while fetal deaths remain the same.

          Regarding SIDS, the graph about halfway down this page does show a drop in SIDS deaths since 2006, but an increase in accidental suffocation / strangulation, which makes me wonder if the deaths are just being reclassified? Or has some policy changed since 2006 that has actually reduced SIDS rates? Anyway, graph: http://www.cdc.gov/sids/data.htm

          • Young CC Prof

            I think you are misunderstanding, I’m afraid. Infant deaths due to severe prematurity and preterm fetal deaths are separate issues, although they share some risk factors.

            The percentage of live births that are premature has actually dropped in the past decade, and I’m not really 100% sure why. This means we have fewer prematurity-related deaths.

            That link didn’t look at whether the liveborn infants who died were premature or not, only whether they died during or after the first month of life. Gestational age was examined only for fetal deaths, and that document shows we haven’t seen much improvement in recent years.

          • Young CC Prof

            As for SIDS, you can see that although deaths attributed to suffocation have gone up slightly, which suggests there may be diagnostic substitution going on, the total rate of sudden unexpected infant death has gone down, mostly between 2009-2011.

            Could be less smoking in the home, could be further attention to safe sleep, I’m not sure.

  • Sue

    My detailed correction is still “awaiting moderation”. SO much science fail!

  • RMY

    Silly SkepticalOB, don’t you know, natural remedies have an effective ratio of negligible (homeopathic) to infinity (herbs are always safe!). So there is no non-therapeutic dose.

    • If there aren’t any possible side effects, there aren’t any beneficial ones either. In other words, the substance is inert. Of course, if something doesn’t have the potential for harm, it can’t hurt you, right?

      Only if you use it because it’s so “safe” and don’t get the proper treatment as a result. Obviously.

  • Zen

    When I first saw the picture at the top, I thought that those were actual questions that Katie Tietje was posing about her remedies, and was going to give her props for her evaluation of pharmacology.

    Never mind.

  • Trixie

    You know, from following MAM’s comments in private or secret Facebook groups, I can tell you that she’s not exactly the picture of health — far from it, because when she has a health problem, she asks Facebook forums instead of going to the doctor or asking a pharmacist.

    • yugaya

      She is like totally ruined down there. A walking anti-homebirth endorsement, and a slowly walking one I’d say because her innards could fall out any minute.

  • no longer drinking the koolaid

    Our local news station is doing a 2 part series on essential oils. I saw the first part last night and don’t even know where to start with everything that is wrong with their reporting.

    • PeggySue

      I have asthma. Essential oils trigger attacks for me. I learned this by working on a unit with an Aromatherapist (must capitalize).

      • SporkParade

        The local essential oil peddler seemed confused when I said that I don’t use all-natural products on my baby because they tend to give me rashes. The sad thing is that she found me on an ostensibly woo-free mothers’ group.

      • Young CC Prof

        Same here. I’ve had many a conversation like this: “What’s in your product? I have allergies.”

        “Oh, it’s all natural!”

        Right, because no one is ever allergic to plants or animals.

  • Box of Salt

    Thank you, Dr Amy, for spelling this out so clearly.

  • jenn

    I saw an artivle on natiral health claiming essential oils cure cancer. A dangerous game.

  • Angela

    She medicates herself more with “natural remedies” than I do with conventional medicine. When I get a cold I never take a thing. Nothing really does anything for me. The most effective thing I do is eat some chicken soup and try to get as much sleep as I can. I’ll take Advil for a headache maybe a few times a year.

    Same with my kids, we rarely find the need to use anything. Why does she need this plethora of “remedies”? Maybe the un-vaccinated aren’t as healthy as they claim.

    • DelphiniumFalcon

      I could take her entire line of pills and it’ll do diddly squat to my colds. Only thing that keeps it from turning into the sinus infection from hell is to use a nasal rinse (with distilled water!) or just take a hot shower to loosen up all the gunk. Which is more of a mechanical removal of mediums for a secondary bacterial infection to take hold than a natural remedy when you get down to it.

      • SporkParade

        I do natural remedies for colds only because really the only thing you can do for them is to reduce the symptoms with some nice, cozy placebos. Now, as soon as I have something that is actually treatable, I am all over the drugs. Bad backache? Dipyrone!

    • Mattie

      The only time I take anything for a cold/flu is if I absolutely have to get up and do things, my favourite thing is nurofen cold and flu which seems to work really well (for me). I’m lucky that for me the rare flu/cold I get is really really bad for 24-48 hours, then I feel fine. If during that time I cannot stay in bed feeling sorry for myself, I take something to enable me to not collapse and carry on haha

    • Sue

      Good point!

      While accusing medicine of being in bed with “Big Pharma”, how is it that these supposedly holistic health care modalities can only offer a “remedy” for every symptom?

      Go to a good GP. Get checked out for anything serious. Get reassurance. Then go home and have chicken soup in bed. No need for the dependence on “remedies”.

      • Elizabeth A

        Our pediatrician’s reccomendation for upwards of 90% of our sick visits has been TLC and non-pharmaceutical comfort measures. Plenty of fluids, BRAT, some warm compresses on that. (She also has a nice talking piece about bringing the kids in whenever we’re worried.) Tylenol or motrin for fevers or pain, as well as non-pharm approaches (rest, ice, compression, elevation.) Now and again, one of the kids will get a bacterial infection and we’ll get antibiotics, but we seldom deal with medicine. As they get older, I call in more rarely, both because they’re seldom sick and because I’ve gotten the hang of those BRAT/RICE/snuggles ‘n’ teevee things.

  • Young CC Prof

    Also, if you’re taking herbs, we’re going to need to know the exact details of when and where to collect it, how to recognize the signs of ripeness that insure optimum potency and minimum toxicity, how to prepare and store it to maintain potency, and how long it will last once stored. Obviously, without precise and reproducible preparation methods, any studies will be unreliable.

    Or, you know, you could just have a chemist take care of that for you. But then it would be a drug.

    • Sue

      Exactly? What’s so “natcheral” about essence-of-plant in a standardised lactose tablet in a glass bottle?

  • DelphiniumFalcon

    I’d also like to know the LD50 for some of these as more isn’t better with a lot of substances.

    • Amy M

      How much water does one have to drink to end up with hyponatremia? That’s probably the LD50.

      • DelphiniumFalcon

        Probably depends on if they toasted their kidneys with something like cat’s claw first!

      • Young CC Prof

        For homeopathy, sure. For some herbs, it’s a whole lot lower.

      • Mariana Baca

        Not all “natural medicine” is homeopathy. Also, Water is not the only dilutant in homeopathy. Some use lactose and gluten which may make symptoms worse for a lot of people. (ok, celiac is really rare, but lactose intolerance is really common).

        • Amy M

          I was joking.

  • Angharad

    I have seen someone claim that the reason essential oils are better than medicine is because they’re natural, so therefore the body knows how to interact with them. This means that the body will work with the oils to produce the desired effect, and that you won’t have any side effects because the body knows what it needs. This is even true when an oil can have many many different effects. The body will choose the one it needs!

    • Amy M

      Ugh. According to lactivists (who are often into natural things), breastmilk works the same way. So should babies be given essential oils, or should adults be given breastmilk? And which essential oil causes weight loss?

      • SporkParade

        If I had to guess based on my online mommy groups, yes to essential oils for babies and breastmilk for non-babies.

    • Young CC Prof

      If my body can choose what effect to get from essential oils, why can’t it just choose what effect to get from my regular lunch?

      • Inmara

        Because your lunch is not alkaline enough, haven’t you heard of almighty pH diet? /sarcasm off

      • Azuran

        That would be awesome!!! Get all the food, without the calories!

    • GuestK

      Arsenic is natural.

  • Roadstergal

    “How is it removed from the body?”

    And what are the metabolites? Are any toxic? How are the metabolites removed from the body? What are the drug/drug interactions with the combinations she recommends?

  • Please, Dr. Amy, let’s not confuse the issue with SCIENCE That’s “unnatural”.

  • Cobalt

    Well, she uses them, and she’s not dead, so they must be safe and effective!

    What do you mean that doesn’t prove anything?

    Surely “placebo” is just an ancient mystic word for “placenta smoothie”!

    • Azuran

      Well….technically, if you think about it, there is nothing more ‘natural’ than the placebo effect.

      • NoLongerCrunching

        Side effect: causes weight loss in wallet in 100% of patients.

        • Cobalt

          Typically yes, but it’s a great tool for parents. I’ve “cured” maladies ranging from pet allergies to coughs to insomnia by giving the kids a tablespoon of watered down juice in a medicine dose cup. It’s a good filter for identifying if the kid is actually sick, and saves a bunch of money and unnecessary drug exposure.

          • Megan

            That is an awesome idea!

          • Cobalt

            Thanks. Like many parenting ideas, it was born in a moment of desperation. If kids don’t make you practical, nothing will.

          • I well remember the “sleeping potion” my father used to make for me as a child when I complained I couldn’t sleep. The preparation was awesome: it needed a special glass [crystal]. There was much measuring of the special ingredient, and afterwards a LOT of noisy stirring with a silver spoon [had to be silver, it was explained to me, or it wouldn’t work] I had to be IN BED when I drank it, because it would work so fast.
            And it did. Every time. I think what I got was water with a bit of honey in it. But at the time, it was magical.

          • Megan

            I’m collecting ideas from all of you guys for my daughter when she gets a bit older!

          • Amy M

            I’m going to try that one…sometimes my sons can’t fall asleep easily, and they wander out of bed claiming dubious symptoms. It’s actually pretty funny sometimes, what they come up with.

          • Sometimes inspiration strikes. My four year old granddaughter was in tears because her new “fairy” doll had lost a shoe. I whipped off the other one and told her that “REAL” fairies never wore shoes, and she was happy. My daughter said, “That was a stroke of genius, Mom”.

            I certainly hadn’t planned that response!